Individual provider Active NPI

Melissa Macklin Antoine, MD

  • Psychiatry Physician
  • Houston, TX
National Provider Identifier
1568691483
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
P8405 Issued in TX
Practice address
3811 Lyons Ave
Houston, TX 77020-8306
Phone
(713) 351-7360
Fax
(713) 351-7361
NPI assigned
Jul 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X P8405 TX Primary

Addresses

Primary practice location

3811 Lyons Ave
Houston, TX 77020-8306

Mailing address

13930 Summerfair CT
Houston, TX 77044-5997
Phone (832) 282-2071

Other identifiers 1

IdentifierTypeStateIssuer
080462703MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160121002634 TX Practitioner - Psychiatry 5799903704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Southern California Keck School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1305 Benson St
Houston, TX 77020-4044
Phone (713) 924-0600

3811 Lyons Ave
Houston, TX 77020-8306
Phone (832) 548-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Community Health Services, Inc CurrentSince Dec 12, 2015 Accepting new patients
Legacy Community Health Services, Inc CurrentSince Dec 12, 2015 Accepting new patients

Locations

13940 Bonham St
Houston, TX 77015
Phone (713) 330-8904

3811 Lyons Ave
Houston, TX 77020
Phone (713) 814-3494

6441 High Star Dr
Houston, TX 77074
Phone (832) 548-5300

5602 Lyons Ave
Houston, TX 77020
Phone (713) 670-0614

1415 California St
Houston, TX 77006
Phone (713) 665-8800

9606 Mesa Dr
Houston, TX 77078
Phone (281) 879-3012

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1568691483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13930 SUMMERFAIR CT",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770445997",
            "telephone_number": "832-282-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 LYONS AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770208306",
            "telephone_number": "713-351-7360",
            "fax_number": "713-351-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOINE",
        "first_name": "MELISSA",
        "middle_name": "MACKLIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-13",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "P8405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080462703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.